Southside Optical Associates LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

SOUTHSIDE OPTICAL ASSOCIATES LLC

Doing business as

Eyetique

Practice address

436 S 27TH St
Pittsburgh, PA 15203-2365

Phone

(412) 246-2407

Fax

(412) 422-0105

NPI assigned

Jul 23, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Norman D. Childs

Title

President

Phone

(412) 246-2407

Specialties & licenses 1

Addresses

Other names 1

• EYETIQUE Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1216771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1246320000000",
    "number": "1790940393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2242 MURRAY AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152172308",
            "telephone_number": "412-246-2407",
            "fax_number": "412-422-0105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "436 S 27TH ST",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152032365",
            "telephone_number": "412-246-2407",
            "fax_number": "412-422-0105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHSIDE OPTICAL ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-23",
        "last_updated": "2009-06-30",
        "status": "A",
        "authorized_official_last_name": "CHILDS",
        "authorized_official_first_name": "NORMAN",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "412-246-2407",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EYETIQUE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Optometrist in Pittsburgh, PA
• Providers in Pittsburgh, PA by specialty
• Optometrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.